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The aim of our study is to evaluate the incidence of post-operative thrombotic complications after abdominal aortic aneurysm surgery in the context of atherosclerosis or infectious aneurysm and its links with preoperative inflammation and hemostasis.
Abdominal aortic aneurysm (AAA) develops in the context of atherosclerosis or infection (aortitis or mycotic aneurysm). AAA and its surgery are associated with pro-thrombotic modifications of hemostasis, which persists in the post-operative period. Pro-thrombotic reactions occur in the intraluminal thrombus. Inflammatory cells recruitment is mediated by adhesion molecules from the activated endothelium, such as "vascular cell adhesion molecule-1" (VCAM-1), "intercellular adhesion molecule-1" (ICAM-1), P-selectin and E-selectin.
In the setting of infection, neutrophil death process occurs, the NETosis, with the liberation of Neutrophil Extracellular Traps (NETs), containing DNA and histones. NETs are associated with thrombosis and various studies have already quantified NETosis biomarkers in plasma from patients with thrombotic disease, such as MPO-DNA (DNA coupled myeloperoxidase).
In the clinical perioperative setting, patients with aortitis scheduled for AAA surgery shwoed exhibit thrombotic events.
The hypothesize was that patients with aortitis have an inflammatory and hemostatic activation different from patients who develop AAA in atherosclerotic condition, and that inflammation is a risk factor of postoperative thrombotic events.
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| Measure | Description | Time Frame |
|---|---|---|
| thrombotic events | Incidence of thrombotic events | first 7 postoperative days after AAA surgery |
| Measure | Description | Time Frame |
|---|---|---|
| white blood cells | white blood cells (G/L), | baseline |
| hemoglobin | hemoglobin (g/dL), | baseline |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with surgery for abdominal aortic aneurysm
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Bordeaux | Bordeaux | France |
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| ID | Term |
|---|---|
| D017544 | Aortic Aneurysm, Abdominal |
| D013927 | Thrombosis |
| ID | Term |
|---|---|
| D001014 | Aortic Aneurysm |
| D000783 | Aneurysm |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| platelets | platelets (G/L), | baseline |
| prothrombin time ratio | prothrombin time ratio (%), | baseline |
| INR | INR | baseline |
| aPTT ratio | aPTT ratio | baseline |
| fibrinogen | fibrinogen (g/L), | baseline |
| CRP | CRP (ng/mL), | baseline |
| interleukin-6 | interleukin-6 (pg/mL), | baseline |
| thrombin generation test | thrombin generation test (lag time (min), | baseline |
| peak | peak (nM), | baseline |
| time to peak | time to peak (min), | baseline |
| ETP | ETP (nM.min), | baseline |
| velocity index | velocity index | baseline |
| von Willebrand factor | von Willebrand factor (%), | baseline |
| soluble P-selectin | soluble P-selectin (ng/mL), | baseline |
| MPO-AND | MPO-AND (% standard) | baseline |
| atherosclerosis | % of patients with preoperative atherosclerosis (number) | baseline |
| Aspirin treatment | % of patients with preoperative treatment by Aspirin (number) | baseline |
| clamping duration | clamping duration (min), | baseline |
| bleeding | bleeding (min), | baseline |
| vascular filling | vascular filling (ml), | baseline |
| tranexamic acid administration | tranexamic acid administration (g), | baseline |
| transfusion | transfusion (pack of red blood cells, plasma volume (ml), | baseline |
| amount of fibrinogen | amount of fibrinogen (g), | baseline |
| amount of heparin | amount of heparin (UI) | baseline |
| Type of postoperative anticoagulation | Type of postoperative anticoagulation: % of patients with unfractionated heparin or low-molecular-weight heparin | baseline |
| Administration way of postoperative anticoagulation | Administration way of postoperative anticoagulation: % of administration intra-venous or subcutaneously | Baseline |
| D001018 |
| Aortic Diseases |
| D016769 | Embolism and Thrombosis |